Following a standard laryngectomy procedure, the recovering laryngectomee is presented with several speech techniques for developing a speaking voice. Such natural techniques include the buccal, pharyngeal and esophageal speech techniques.
The buccal speech technique involves developing sound by squeezing air within the mouth between the cheeks, tongue and palate to create a form of speech. Pharyngeal speech is created by trapping air in the back of the throat with the base of the tongue or against the soft or hard palate. However, both the buccal speech and pharyngeal speech techniques create forms of speech which are incomprehensible.
The laryngectomee creates esophageal speech by injecting air into the upper esophagus to produce a sound which can be formed into normal speech. Unfortunately for the recovering laryngectomee, esophageal speech is often difficult and time consuming to learn.
Electronic or mechanical speech aids (or artificial larynxes) are other options which are available to the rehabilitating laryngectomee. Although existing mechanical and electronic speaking devices are an acceptable substitute for the human voice, they tend to create a speaking tone which is considered to be unnatural and often requires the use of the laryngectomee's hands or the creation of a fistula between the tracheostoma and the pharynx for surgical implantation of the device. Furthermore, some mechanical devices are not operative in the absence of the vocal cords.
These mechanical and electronic speaking devices are well known in the prior art. One example of a mechanical speaking device is found in the Rangoni, et al. patent (U.S. Pat. No. 4,809,693) which discloses a tracheal cannula fitted with a mechanically operated valve to direct air over the vocal cords to produce speech. Obviously, this device is of no service to the patient who has undergone a total laryngectomy where the vocal cords have been removed.
Another example is the Blom, et al. patent document (European Patent Application 0 078 685) which discloses a tracheal valve having a valve assembly for supporting a flexible and lightweight diaphragm. During exhalation, the diaphragm extends to close the valve directing air to the larynx or to an internal voice prosthesis. However, the Blom, et al. device is only operable in the presence of the vocal cords or in combination with a separate voice prosthesis which is received within a fistula. Thus, if the vocal cords of the laryngectomee are not present, the Blom, et al. device requires additional surgery to implant a voice prosthesis.
One example of an electronic speech apparatus is disclosed in U.S. Pat. No. 4,272,647 to Veit, et al. The Veit, et al. patent discloses a speech aid apparatus for laryngectomees which when held against the throat generates sound in the cavity of the mouth and pharynx. By using normal speaking movements, these sounds may be shaped into comprehensible speech. However, one disadvantage of the Veit, et al. device includes constant use of the laryngectomee's hands to create speech. If the laryngectomee's hands are otherwise occupied, speech is not possible utilizing the Veit, et al. device.
Thus, it is an object of the present invention to overcome the disadvantages of the speaking devices described above. The present invention is a tracheal speaking tube which is received within the stoma of a laryngectomee to assist in the creation of speech. The device includes an air flow altering means and an internal vibrating means which is disposed upon the upper interior portion of the tube. The vibrating device may be breath-powered or electro-mechanical. In the present invention, the laryngectomee initiates speech by exhaling forcefully to close the air flow altering means which is located within the speaking tube. Air, trapped within the speaking tube, is directed to the vibrating device which creates vibrations which are then transported to the upper wall of the stoma. The vibrations travel through the tissue of the neck to vibrate the walls of the esophagus. As the walls of the esophagus vibrate, speech is created using normal oral, labial and glossal articulation. Thus, the present invention allows the creation of natural comprehensible speech by using the walls of the esophagus as opposed to an artificial larynx. Because the laryngectomee is able to control the production of speech as he did preoperatively with breath control and normal articulation, phrasing is natural.
The present invention is also advantageous over the prior art because it does not require the use of the laryngectomee's hands or additional surgery to implant a voice prosthesis. Using the present device, the laryngectomee is able to communicate while engaging in other activities which may require use of the hands. Most importantly, the present invention is an integral device which is easily inserted within the tracheostoma of the laryngectomee to assist in the creation of speech with little learning difficulty.
Furthermore, the device of the present invention is easily cleansed of pulmonary secretions due to the provision of a removable inner cannula. Lastly, the internal elements of the speaking tube or inner cannula are streamlined to facilitate normal breathing and the entire device is easily concealable.